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Debt Solutions Intake Form

Complete what you know below so MBA Financial Tax & Accounting LLC can better understand your  debt, payment pressure, collection activity, and financial goals. 

Debt-reduction planning is not a promise of a specific savings amount, payoff date, settlement, creditor  decision, credit-score improvement, or financial result. The purpose is to review the facts and help identify  practical next steps. 

Do not submit Social Security numbers, bank-account numbers, passwords, or confidential records through  this public form. After intake, use the secure client portal for confidential documents.

Debt Solutions Intake Form

If you received lawsuit papers, a garnishment notice, court paperwork, a levy notice, lien notice, or any urgent response deadline, call immediately before submitting this form.

Are you contacting us as:
Individual
Business
Both
Debt Type
Approximate Total Debt
Approximate Monthly Debt Payments
Are accounts current, behind, in collections, charged off, or in court?
Current
Behind on Payments
In Collections
Charged Off
In Court
Mixed Status
Not Sure
Have you received collection letters, lawsuit papers, garnishment notice, levy notice, lien notice, or court paperwork?
Yes
No
Is there a court date, answer deadline, or urgent response date?
No
Yes
Do you want help with budgeting, debt priority, repayment strategy, settlement options, tax debt, or all of the above?

Include as much information as you can. This helps us review your situation before contacting you.

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One Step Closer

Our goal is to provide you with a clearer understanding and strategy for debt solutions. Rest assured that our team brings decades of tax, accounting, and financial review experience to help you understand your options and next steps.

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